The purpose of this study was to compare the efficacy and effects of exercise programming (Study group, n = 11) vs traditional outpatient therapy (Home group, n = 10) in burned children (> 40% body surface area). This was a prospective, randomized, controlled trial in a hospital-based children's wellness center. Twenty-one patients (13 boys and 8 girls) averaging 10.6 +/- 0.9 years and TBSA = 59.7 +/- 3.1% were evaluated 6 and 9 months postburn. Moderate intensity, progressive resistance and aerobic exercise conducted 3 times weekly for 1 hour were a supplement to standard therapy over 12 weeks. Muscular strength and functional outcome significantly increased in both groups (P < .05). Improvements in strength (80.1 vs 37.7%) and distance walked (39.5 vs 12.5%) were significantly greater for Study vs Home groups, respectively, P < .05. We conclude that exercise programming may be safely included in rehabilitation programs for severely burned children and can be effective in increasing muscular strength and functional outcome.